局部用皮质类固醇预防乳腺癌患者急性放射性皮炎的有效性：一项更新的系统评价和荟萃分析。

Effectiveness of topical corticosteroids on the prevention of acute radiation dermatitis in patients with breast cancer: An updated systematic review and meta-analysis.

作者信息

Liu Weichao, Wang Liping, Meng Dijuan, Hong Chengang, Zhang Qianyu, Yang Jinghan

机构信息

School of Nursing, Hangzhou Normal University, Hangzhou, China.

School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Asia Pac J Oncol Nurs. 2024 Jul 6;11(9):100553. doi: 10.1016/j.apjon.2024.100553. eCollection 2024 Sep.

DOI:10.1016/j.apjon.2024.100553

PMID:39185079

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11342102/

Abstract

OBJECTIVES

To evaluate the effect of topical corticosteroids (TCS) in preventing acute radiation dermatitis in patients with breast cancer.

METHODS

An updated systematic review and meta-analysis were conducted following the preferred reporting items for systematic reviews and meta-analyses. Randomized controlled trials (RCTs) in six English databases (PubMed, Web of Science, Scopus, CINAHL, Cochrane Library, Embase), three Chinese databases (Sinomed, China National Knowledge Infrastructure, Cqvip), and two clinical trial registration platforms (CHICTR, Clinicaltrials.gov) were systematically searched from inception to 1 February 2024.

RESULTS

Thirteen RCTs were included, with 1172 patients in this updated review. Meta-analysis showed that TCS reduced the rate of moist desquamation (OR = 0.31; 95% CI = [0.22, 0.44]; < 0.01), the incidence of Radiation Therapy Oncology Group ratings of grade 2 or higher (OR = 0.22; 95% CI = [0.14, 0.32]; < 0.01), the incidence of Common Terminology Criteria for Adverse Events ratings of grade 2 or higher (OR = 0.56; 95% CI = [0.37, 0.84]; < 0.01), the mean score of radiation dermatitis (SMD = -0.46; 95% CI = [-0.59, -0.34]; < 0.01), skin erythema and hyperpigmentation readings, and improved subjective symptoms.

CONCLUSIONS

TCS can effectively prevent acute radiation dermatitis in patients with breast cancer.

SYSTEMATIC REVIEW REGISTRATION

Prospero (CRD42024507890).

摘要

目的

评估局部用皮质类固醇（TCS）预防乳腺癌患者急性放射性皮炎的效果。

方法

按照系统评价和Meta分析的首选报告项目进行了一项更新的系统评价和Meta分析。对六个英文数据库（PubMed、Web of Science、Scopus、CINAHL、Cochrane图书馆、Embase）、三个中文数据库（中国生物医学文献数据库、中国知网、维普资讯）和两个临床试验注册平台（中国临床试验注册中心、Clinicaltrials.gov）从建库至2024年2月1日进行系统检索。

结果

纳入13项随机对照试验，本更新评价中有1172例患者。Meta分析显示，TCS降低了湿性脱屑发生率（OR = 0.31；95%CI = [0.22, 0.44]；P < 0.01）、放射治疗肿瘤学组2级或更高等级评定的发生率（OR = 0.22；95%CI = [0.14, 0.32]；P < 0.01）、不良事件通用术语标准2级或更高等级评定的发生率（OR = 0.56；95%CI = [0.37, 0.84]；P < 0.01）、放射性皮炎的平均评分（SMD = -0.46；95%CI = [-0.59, -0.34]；P < 0.01）、皮肤红斑和色素沉着读数，并改善了主观症状。